CA2380925A1 - Ph sensor for indicating the ph of a sample, the fabrication and use thereof - Google Patents
Ph sensor for indicating the ph of a sample, the fabrication and use thereof Download PDFInfo
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- CA2380925A1 CA2380925A1 CA002380925A CA2380925A CA2380925A1 CA 2380925 A1 CA2380925 A1 CA 2380925A1 CA 002380925 A CA002380925 A CA 002380925A CA 2380925 A CA2380925 A CA 2380925A CA 2380925 A1 CA2380925 A1 CA 2380925A1
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N31/00—Investigating or analysing non-biological materials by the use of the chemical methods specified in the subgroup; Apparatus specially adapted for such methods
- G01N31/22—Investigating or analysing non-biological materials by the use of the chemical methods specified in the subgroup; Apparatus specially adapted for such methods using chemical indicators
- G01N31/221—Investigating or analysing non-biological materials by the use of the chemical methods specified in the subgroup; Apparatus specially adapted for such methods using chemical indicators for investigating pH value
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
- G01N21/75—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated
- G01N21/77—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated by observing the effect on a chemical indicator
- G01N21/78—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated by observing the effect on a chemical indicator producing a change of colour
- G01N21/80—Indicating pH value
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Abstract
A pH sensor for the visual or optical indication of the pH of a sample. The pH
sensor includes a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one pH indicator dye immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
sensor includes a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one pH indicator dye immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
Description
w0 01/13097 PCT/US00/21129 PH SENSOR FOR INDICATING THE PH OF A SAMPLE, THE FABRICATION AND USE THEREOF
FIELD AND BACKGROUND OF THE INVENTION
s The present invention relates to a pH sensor for the visual or optical indication of the pH of a sample, the sensor having a mechanically stable support and an indicator dye immobilized thereby.
The invention further relates to a process for fabricating a pH sensor for visual or optical indication of the pH of a sample, in which a pH
indicator dye is immobilized by a mechanically stable support. such that the indicator dye does not appreciatively bleed when contacted with the sample. In addition, the invention also relates to the use of a pH sensor of this type. Finally, the invention also relates to an efficient method of selecting pH indicator d~~es and/or dyes ratio for obtaining a pH indicator t s dye mixture which is sensitive to a subtle change in pH.
The optical measurement of the pH goes back to the finding that certain d~~es, (such as, for example, litmus and tea) react to the pH of a sample by changing their color and are thus able to indicate the pH of a sample. A selection of suitable dyes (indicators), together with the pH
2o ranges within which they change color, is found, for example, in "Indicators", E. Bishop, Pergamon Press, 1972, chapter 3, which is incorporated herein by reference.
The first pH-sensitive strip materials were obtained by immersing a paper strip in a dye solution. The dye in color strips of this type is 2s bound to the support by absorption. This has the drawback that the dye can be washed out by the sample, which makes such strips unsuitable for applications wherein indicator contamination is unacceptable and for continuous processes. In addition, in many cases, upon dn~ing such strips loose their pH indicative color.
w0 01/13097 PCT/US00/21129 By means of chemical or physical immobilization of dyes washing out can be prevented. Immobilized pH-sensitive materials are therefore suitable for the continuous measurement of pH and for applications wherein indicator contamination are unacceptable.
s An early study of bacterial vaginosis (BV) involved comparisons of the pH of vaginal fluids of women known to be suffering from BV
with those known to be free of the disease. Gardner, H. L., et al., Am. J.
Obstet. Gynecol. 69:962 (1955). All of the BV positive women in the study were determined to have a vaginal fluid pH greater than 4.5, and 91 % of these women had a vaginal fluid pH greater than ~Ø Of the normal (disease-free) women in the test, 92 % were found to have vaginal pH between 4.0 and 4.7. The conclusion drawn from the study was that a vaginal pH equal to or greater than 5.0 in conjunction with other clinical criteria was indicative of the presence of BV.
is Subsequent studies culminating by Amsel, R., et al., Am. J. Med.
74:14-22 (1983), resulted in a reduction of the pH threshold for BV to 4.5, and established the remaining criteria as vaginal fluid homogeneity, the whiff test (treatment with alkali followed by an olfactory test to detect for an amine odor), and the presence of clue cells. These are commonly 2o referred to as the Amsel clinical criteria for BV. The conclusion was based on a study group of 397 women in which 81 % of BV positive women were found to have a pH greater than 4.5 while only 23 % of the normal women were found to have a vaginal fluid pH greater than 4.5.
Studies subsequent to the report by Amsel et al. have now adjusted 2s the pH threshold to 4.7. One of these is the study of Holst, E., J. Clin.
Microbiol. 28:203-2039 (1990), in which 100 % of the women diagnosed as BV positive by the Amsel criteria were reported to have vaginal fluid pH greater than 4.7. Another is the study by Eschenbach, D. A., Am. J. Obstet. Gvnecol. 168(4):819-828 (1988), in which all 2~7 w0 01/13097 PCT/US00/21129 p women in the study group who had at least 20 % clue cells were shown to have a vaginal fluid pH greater than or equal to 4.7, leading to the conclusion that a threshold value of 4.7 correlated best with the other clinical evidence of BV. Krohn, M. A., et al., J. Clin. Microbiol.
s 27(6):1266-1271 (1989), also verified the correlation between the vaginal fluid pH threshold of 4.7 and the presence of clue cells, and Hohnes, K.
K., and coworkers further confirmed the pH 4.7 threshold as an indicator of BV--Holmes, K. K., et al., eds., Sexually Transmitted Diseases, McGraw-Hill, New York (1990), Chapter 46:527-545 (Hohnes, K. K., et al.), and Chapter 47:547-5~9 (Hillier, S. L., et al.).
Colorimetric tests for elevated vaginal fluid pH have used nitrazine yellow as an indicator. Nitrazine yellow is a monoazo dye that is bright yellow at pH 6.0 and bright blue at pH 7.2, and has a grey-green midpoint at pH 6.6. In the range of interest for testing vaginal fluid, ~s however, which is approximately 3.~ to 6Ø the change occurs in subtle progressions of grey-green that are difficult to interpret.
pH thresholds are useful indicators in diagnosing a variety of other biological conditions, in both humans and animals, and a large number of colorimetric indicators are known and commercially available. Selection 20 of the appropriate indicator is not always a simple task, however, and the choices are often limited, particularly when a specific color change is desired and when stability of the indicator is a consideration.
Normal bovine milk, for example, has a pH of 6.5 to 6.8, and it has been reported (N. Z. J. Sci. Technol. 27:258 (1945)) that bovine milk 2s with a pH greater than 6.8 may indicate the presence of bovine mastitis.
The difficulties of detecting a pH deviation of such a small magnitude using conventional paper indicator strips are discussed above.
A study specifically directed to bovine mastitis was reported in J.
Dairv Sci. 68: 1263-1269 (198x). The purpose of the study was to w0 01/13097 PCT/US00/21129 determine the suitability of using absorbent blotting paper impregnated with the pH indicator bromthymol blue to test the pH of bovine milk as a method of detecting subclinical bovine mastitis. Milk was added to the indicator-treated paper, and the color of the pH indicator spot was scored s on a scale of 1 to 4, where 1 (pale green) was assessed as normal (negative), and 2, 3 and 4 (increasing from moderate green to dark blue-green) were considered abnormal (positive). The pH of the milk was also determined electronically with a carefully calibrated pH meter.
The test results illustrated the difficulty in defining accurately the color ~o of the test area: the predictive value of a positive colorimetric test ranged from 49 % to 52 % (i.e.. 51 % to 48 % of the results were false positives).
As expected, an increase in the test score was accompanied by an increase in the severity of mastitis as defined by other diagnostic Is measures. However, in milk from animals with less severe mastitis, the considerable overlapping of results highlighted the possible error in interpretation of indicator scores. The wide variation of milk pH as determined electronically within each BTB (Brow Thvmol Blue) color score showed that the indicator results were not closely related to pH.
2o The investigators stressed the importance of using color comparators which resemble as closely as possible the actual pH test method being utilized. If the colorimetric milk pH test results were to be interpreted immediately, it was important to use comparators that were also wetted with milk. If the calorimetric pH test results were to be determined after 2s the milk spots had dried, it was advantageous to use dn~ comparators.
Returning to bacterial vaginosis, the whiff test, which is one of the Amsel criteria, originated in a study by Pheifer, et al., N. Engl. J. Med.
298:1429-1434 (1978), that reported the presence of a characteristic fishy amine odor upon the addition of 10 ° o KOH to a vaginal fluid specimen w0 01/13097 PCT/US00/21129 from a woman with BV. The odor is caused by the alkaline volatilization of amine salts found in the vaginal fluid of women with BV.
Unfortunately. the test is highly subjective, it exposes the health care worker to potential biological hazards, and it is disagreeable and s vulnerable to error, since it is performed on a microscope slide which, due to the transient nature of the amine odor, must be placed directly under the nose and sniffed immediately after the addition of the KOH.
Alternatives to the whiff test are analyrtical procedures such as high voltage electrophoresis (Chen, K. C. S., et al., J. Clin. Invest.
~0 63:828-835 (1979)). thin-layer chromatography (Chen, K. C. S., et al., J.
Infect. Dis. 145:337-345 (1982), and Sanderson, B. E., et al., Br. J.
Vener. Dis. 59:302-305 (1983)), gas chromatography (Graven, M. G., et al. Obstet. Gynecol. 67:229-237 (1986), and Dravenieks, A., et al., J.
Pharma. Sc. 59:495-501 ( 1970)), and high-performance liquid Is chromatography (Cook, R. L., et al., J. Clin. Microbiol. 30:870-877 ( I 992)). These procedures, although more accurate and reliable than the whiff test, are expensive, time-consuming, and not suitable for on-site testing in a physician's office or clinic.
Clue cells, which constitute a further Amsel criterion, are 2o independently correlated with BV, and in the hands of a skilled microscopist are a very sensitive and specific indication of this infection.
Clue cells are squamous vaginal epithelial cells found in vaginal fluid when BV is present. The cells are covered with numerous bacteria, giving them a stippled or granular appearance, and their borders are ?s obscured or fuzzy because of the adherence of numerous rods or cocci.
According to standard clinical practice, a diagnosis of BV is established when at least 20% of the detectable epithelial cells are clue cells.
Holmes, et al., Sexually Transmitted Diseases. 2d ed., McGraw-Hill, Inc., New York. 1990.
Distinguishing between true clue cells in which the adherent bacteria completely obscure the edges of the cells and cells with simply a few adherent bacteria requires training and experience. One source of error is similarity in appearance between clue cells and trichomonads, s white blood cells and other vaginal fluid components, frequently resulting in an incorrect identification of these cells as clue cells, and therefore false positive test results. Another is that clue cells when present are frequently obscured by numerous vaginal fluid components causing the clinician to miss the clue cells completely or to quantify them ~o at levels below their actual level. This can result in a false negative test result. Therefore, it would be highl~~ desirable to have a distinct analyte that is accurately and conveniently monitored and whose presence is correlated with clue cells.
U.S. Pat. No. 5,217,444 to Schoenfeld teaches an absorbent pad, for use in absorbing secretions from a person's body, which includes a pH
indicator material indicating by a color change the acidity or alkalinity of a liquid coming into contact with it. The pH indicator material is wetted by the secretions absorbed by the pad. and thereby provides an indication of the health condition of the person's body.
2o U.S. Pat. No. 5,853,669 to Wolfbeis teaches a hydrophilic accommodating layer disposed on a hydrophobic mechanically stable support element, which layer contains an indicator dye proper in an immobilized form for the purpose of visual or optical indication of the pH of a sample which can be used as the pH indicator in the pad of 2s Schoenfeld and in other applications as well.
SUMMARY OF THE INVENTION
One object of the present invention is to improve a pH sensor of the type mentioned in the preamble and a process for fabricating a pH
sensor of this type, so as to enable a simple fabrication or even mass production of pH sensors which are inexpensive and thus suitable as an expendable pH sensor.
Another object of the present invention is to provide hygienic pads s in which a pH sensor as herein described is incorporated for monitoring a user's health condition.
Still another object of the present invention is to provide an efficient method of selecting pH indicator dyes and/or dyes ratio for obtaining a pH indicator dye mixture which is sensitive to a subtle change in pH.
Thus, according to one aspect of the present invention there is provided a pH sensor for the visual or optical indication of the pH of a sample, the pH sensor comprising a hydrophilic, intrinsically charged or neutral, synthetic membrane and at least one pH indicator dye immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
According to another aspect of the present invention there is provided a method of manufacturing a non-bleeding pH sensor, the 2o method comprising the step of immobilizing at least one pH indicator dye onto a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
2s According to yet another aspect of the present invention there is provided an absorbent body for absorbing vaginal discharge of a person, comprising an absorbent material and a pH sensor being combined therewith for the visual or optical indication of the pH of the vaginal discharge, the pH sensor including a hydrophilic. optionally intrinsically h charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid, the pH sensor being included in the absorbent body so as s to be wetted by the secretions absorbed by the absorbent material, thereby providing an indication of the health condition of the person's body.
According to still another aspect of the present invention there is provided a method of providing an indication of the health condition of a person's body, the method comprising the steps of (a) collecting vaginal discharge of the person into an absorbent body including an absorbent material and a pH sensor being combined therewith for the visual or optical indication of the pH of the vaginal discharge, the pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, ~ s so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid, the pH sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material; and (b) optically inspecting the pH sensor for a color change, thereby providing an 2o indication of the health condition of the person's body.
According to a further aspect of the present invention there is provided a method of producing an absorbent body for absorbing vaginal discharge of a person and for providing an indication of the health condition of the person's body, the method comprising the step of 2s combining an absorbent material and a pH sensor, the pH sensor being for the visual or optical indication of the pH of the vaginal discharge, the pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto. so as to prevent appreciated bleeding of the at least one indicator w0 01/13097 PCT/US00/21129 dye from the synthetic membrane upon immersion in an aqueous liquid, the pH sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material, thereby providing an indication of the health condition of the person's body.
s According to further features in preferred embodiments of the invention described below. the at least one pH indicator dye is sensitive to a subtle change in pH of less than N pH units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units and 0.1 pH units.
to According io still further features in the described preferred embodiments the hydrophilic synthetic membrane is positively charged.
According to still further features in the described preferred embodiments the hydrophilic synthetic membrane is negatively charged.
According to still further features in the described preferred t, embodiments the hydrophilic synthetic membrane is amphoteric.
According to still further features in the described preferred embodiments the hydrophilic synthetic membrane is a Nylon membrane.
According to still further features in the described preferred embodiments the Nylon is Nylon 6.6.
2o According to still further features in the described preferred embodiments hydrophilic synthetic membrane is a polyamide membrane.
According to still further features in the described preferred embodiments hydrophilic synthetic membrane is an arylamide membrane.
According to still further features in the described preferred ?s embodiments the at least one pH indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
According to an additional aspect of the present invention there is provided a method of selecting pH indicator dyes and dyes ratio for obtaining a pH indicator dve mixture which is sensitive to a subtle w0 01/13097 PCT/US00/21129 change in pH, the method comprising the steps of (a) providing a plurality of transparent containers; (b) dividing the plurality of transparent containers into pH groups by filling containers of each of the pII groups with a buffered solution of a predetermined pH value; (c) s introducing into each of the plurality of containers a single pH indicator dye of a known concentration, such that different containers of a single group of containers include different pH indicator dyes and optionally different concentrations of a specific pH indicator dye; (d) selecting at least two containers of a specific pH group, each of the at least two ~ o containers including a different pH indicator dye and positioning the at least two containers against a light source so as to optically monitor a color obtained by combining color contributions of each of the at least two containers; and (d) optionally repeating step (d) with containers of one or more of the pH groups until identifying pH indicator dyes and/or dyes ratio, such that when mixed to form the pH indicator dye mixture will be sensitive to the subtle change in pH.
According to further features in preferred embodiments of the invention described below, the subtle chance in pH is of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units and 0.1 pH units.
The present invention successfully addresses the shortcomings of the presently known configurations by providing a pH sensor for the visual or optical indication of the pH of a sample, an method of manufacturing same, an absorbent body for absorbing vaginal discharge ?s of a person including same, a method of providing an indication of the health condition of a person's body using same, a method of producing an absorbent body for absorbing vaginal discharge of a person and for providing an indication of the health condition of the person's body and a w0 01/13097 PCT/US00/21129 method of selecting pH indicator dyes and dyes ratio for obtaining a pH
indicator dye mixture which is sensitive to a subtle change in pH.
BRIEF DESCRIPTION OF THE DRAWINGS
s The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:
FIG. 1 is a top view of a pH sensor according to the present mvent~on;
FIG. 2 is a top view of a hygienic pad including the pH sensor according to the present invention;
FIG. 3 is a perspective view of a tampon including the pH sensor according to the present invention; and FIG. 4 is a graph showing the change in color as a function of pH
for 0.1 % Bromocresol Green as is compared with a mixture of 1 volume t s of Bromocresol Green mixed with 3 volumes of 0.1 % Methyl Orange.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present invention is of a pH sensor for the visual or optical indication of the pH of a sample which can be used in an absorbent body 2o for absorbing vaginal discharge of a person. Specif cally the present invention can be used to provide an indication of the health condition of a person's body. The present invention is further of a method of manufacturing a pH sensor for the visual or optical indication of the pH
of a sample, a method of producing an absorbent body for absorbing 2s vaginal discharge of a person and for providing an indication of the health condition of the person's body and a method of selecting pH
indicator dyes and/or dyes ratio for obtaining a pH indicator dye mixture which is sensitive to a subtle change in pH.
l~
The principles and operation of the present invention may be better understood with reference to the drawings and accompanying descriptions.
Before explaining a1 least one embodiment of the invention in s detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments or of being practiced or carried out in various ways. Also, it is to be understood that i o the phraseology and terminology employed herein is for the purpose of description and should not be regarded as limiting.
As shown in Figure l, according to one aspect of the present invention there is provided a pH sensor 10 for the visual or optical indication of the pH of a sample. pH sensor 10 includes a hydrophilic, > > optionally intrinsically charged or neutral, synthetic membrane and at least one pH indicator d5~e immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
As used herein in the specification and in the claims section that 2o follows, the phrase "a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane" refers to non-natural membranes which are positively charged, such as the BIODYNE B/PLUS membrane by PALL
Gelman Laboratory, membranes which are negatively charged, such as the BIODYNE C membrane by PALL Gelman Laboratory, membranes 2s which are amphoteric, such as the BIODYNE A membrane by PALL
Gehnan Laboratory. Such a synthetic membrane can be made of any suitable synthetic polymer, such as, but not limited to polyamide (Nylon.
e.g., Nylon 6.6) and arylamide. Synthetic membranes are presently preferred over fibrous natural membranes such as nitrocellulose based membranes because it was experimentally determined that (t) such membranes better maintain their structural integrity under wider pH
ranges as is compared with natural membranes such as cellulose or nitrocellulose based membranes; and (ii) such membranes readily s immobilize a plurality of pH indicator dyes.
As used herein in the specification and in the claims section that follows, the phrase "at least one pH indicator d5~e" refers to a single pH
indicator dye or a mixture of at least two different pH indicator dyes, wherein in different mixtures each of the at least one pH indicator dye ~o may be present in a different concentration.
As used herein in the specification and in the claims section that follows, the phrase "appreciated bleeding" refers to eye detectable leakage of the at least one pH indicator dye into an aqueous liquid, such as a buffer solution, in a predetermined pH range, e.g., of 2 pH units, t, through which color change of the pH indicator dye is experienced, over a predetermined time period, e.g., 24 hours, at a temperature beriveen e.g., 22 °C and 37 °C. The phrase also refers to eye detectable leakage of the at least one pH indicator dye onto a wet white fibrous material.
According to another aspect of the present invention there is 2o provided a method of manufacturing a non-bleeding pH sensor. The method according to this aspect of the present invention is effected by immobilizing at least one pH indicator dye onto a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic 2s membrane upon immersion in an aqueous liquid. Immobilization according to this aspect of the present invention can be effected by immersing the membrane in an aqueous solution of the at least one pH
indicator in an appropriate concentration. ranging between 0.01 w/v and 1 w/v % for several hours, e.g.. at least 4 hours, preferably at least 6 1 ~1 hours, more preferably at least 10 hours. still more preferably at least 15 or 20 hours, followed by washing the membrane in a wash solution and immobilizing the at least one pI-I indicator dye thereto by an immobilization method, such as. but not limited to, placing the membrane s over an absorbing material and drying the membrane under low humidity conditions (e.g., not more than 30 % air humidity) at, for example, room temperature, for several hours. It was experimentally determined that using the above protocol, a variety of pH indicator dyes were immobilized to an amphoteric Nylon membrane and showed no appreciated bleeding thereafter.
A unique feature of the protocol herein described is the stability of the color change of pH sensor 10. Thus, while prior art pH strips change color, the color is maintained thereby as long as the strip is kept humid, however, the color fades upon drying. While practicing the above Is protocol, the inventors were surprised to find out that for a plurality of pH indicators tested, the color change developed following pH change remained substantially unchanged and in some cases became more pronounced after drying. For example, by mixing I volume of 0.1 Bromocresol Green with 3 volumes of Methyl Orange and immobilizing 2o the pH indicator dyes mixture onto an amphoteric Nylon membrane as herein described a pH sensor was obtained which was lemonish at pHs 4.2 and 4.4 and turned bluish-green at pH 4.6. The bluish-green color was maintained substantially unchanged also after drying the membrane and keeping it dry for over two weeks.
2s According to a preferred embodiment, both the aqueous solution and the wash solution are either a buffered solution or a non-buffered solution, respectively, having a pH value in a range of less than ~ 0.5-1.0 pH units of the pH value inducing a color change on the at least one pH
indicator.
1i Thus, the present invention provides an assay for pairing appropriate membranes with appropriate pH indicator dyes. According to this assay, any one of the above described membranes is tested for appreciated bleeding following the immobilization protocol as herein described. This assay can be rendered more sensitive by spectroscopically monitoring the bleeding to thereby determine bleeding, if any.
As shown in Figures 2-3, according to yet another aspect of the present invention there is provided an absorbent body 14 for absorbing ~ o vaginal discharge of a person. Absorbent body 14 includes an absorbent material 16 which, as shown in Figure 2, can be arranged in a flattened layers configuration, such a hygienic pad, or, as specifically shown in Figure 3, rolled or folded into a compact configuration, such as a tampon.
In any case, absorbent body 14 further includes a pH sensor, such as pH
t > sensor 10 as described hereinabove, which is combined with material 16 for the visual or optical indication of the pH of the vaginal discharge.
Thus, pH sensor 10 is included in absorbent body 14 so as to be wetted by the secretions absorbed by absorbent material 16, thereby to provide an indication of the health condition of the person's body, as is further 2o detailed in the background section above and in U.S. Pat. Nos. x,217,444 to Schoenfeld and 5,83,669 to Wolfbeis both are incorporated by reference as if fully set forth herein. pH sensor 10 can be located at any location with respect to, for example, pad 14 of Figure 2. It is preferably centered. It can be located at either side of pad 14. Similarly, pH sensor ?s 10 can be located at any location with respect to, for example, tampon 14 of Figure 3. It is preferably centered. In both cases, pH sensor 10 can be either externally attached to material 16 body 14 or internally embedded between layers of material 16. Material 16 can be any absorbent substance, including. but not limited to, natural fibers, such as cotton w0 01/13097 PCT/US00/21129 fibers, or a gelating substance, as well known in the art. Additional layers, such as an external protective, water impermeable, layer 18 can be employed, as well known in the art. Such a protective layer 18 is preferably selected transparent, so as to enable a user to view pH sensor and any color change thereof therethrough.
According to still another aspect of the present invention there is provided a method of providing an indication of the health condition of a person's body. The method according to this aspect of the present invention is effected by collecting vaginal discharge of the person into an to absorbent body such as absorbent body 14 described hereinabove and optically inspecting, e.g., by a colorimeter or by eye inspection, the pH
sensor for a color change, thereby providing an indication of the health condition of the person's body in relation to bacterial vaginosis, all as further detailed in the background section above.
1 s According to a further aspect of the present invention there is provided a method of producing an absorbent body for absorbing vaginal discharge of a person and for providing an indication of the health condition of the person's body. The method according to this aspect of the present invention is effected by combining an absorbent material and 2o a pH sensor as further detailed hereinabove.
As is further detailed in the background section above subtle pH
changes are in some cases indicative of a pathological state. Therefore, according to a preferred embodiment of the present invention. the at least one pH indicator dye is selected sensitive to a subtle change in pH, such 2s as, but not limited to, less than 0.~ pH units, less than 0.4 pH units, less than 0.3 pH units, less than 0.2 pH units or less than 0.1 pH units. The sensitivity should be tailored to the application. Thus, for diagnosis of bacterial vaginosis pH change of about 0.4 pH units is of choice. In this case. the at least one pH indicator dye produces a color chance at a pH of w0 01/13097 PCT/US00/21129 between pH value of 4.0 and 5Ø preferably between pH value of 4.2 and 4.6.
According to an additional aspect of the present invention there is provided a method of selecting pH indicator dye combinations and dyes s ratios) for obtaining a pH indicator dye mixture which is sensitive to a subtle change in pH. The method according to this aspect of the present invention is effected by implementing the following method steps, in which, in a first step, a plurality of transparent containers are provided.
The containers are preferably cubic containers. such as quvettes, e.g., quartz or glass quvettes. In a second step of the method according to this aspect of the present invention the plurality of transparent containers are divided into pH groups by filling containers of each of the pH groups with a buffered solution of a predetermined pH value. Containers of different pH groups are filled with buffers which differ by subtle pH
t, values, such as less than 0.~ pH units, less than 0.4 pH units, less than 0.3 pH units, less than 0.2 pH units, less than 0.1 pH units or for some applications less than 0.05 pH units, and the groups cover a suitable pH
range of e.g., about I .0 pH unit. say betveen pH 4.0 and pH ~Ø Then, into each of the plurality of containers a single pH indicator dye of a 2o known concentration is introduced, such that different containers of a single group of containers include different pH indicator dyes and optionally different concentrations of a specific pH indicator dye.
Thereafter, at least two containers of a specific pH group are selected.
Each of the at least two containers include a different pH indicator dye.
FIELD AND BACKGROUND OF THE INVENTION
s The present invention relates to a pH sensor for the visual or optical indication of the pH of a sample, the sensor having a mechanically stable support and an indicator dye immobilized thereby.
The invention further relates to a process for fabricating a pH sensor for visual or optical indication of the pH of a sample, in which a pH
indicator dye is immobilized by a mechanically stable support. such that the indicator dye does not appreciatively bleed when contacted with the sample. In addition, the invention also relates to the use of a pH sensor of this type. Finally, the invention also relates to an efficient method of selecting pH indicator d~~es and/or dyes ratio for obtaining a pH indicator t s dye mixture which is sensitive to a subtle change in pH.
The optical measurement of the pH goes back to the finding that certain d~~es, (such as, for example, litmus and tea) react to the pH of a sample by changing their color and are thus able to indicate the pH of a sample. A selection of suitable dyes (indicators), together with the pH
2o ranges within which they change color, is found, for example, in "Indicators", E. Bishop, Pergamon Press, 1972, chapter 3, which is incorporated herein by reference.
The first pH-sensitive strip materials were obtained by immersing a paper strip in a dye solution. The dye in color strips of this type is 2s bound to the support by absorption. This has the drawback that the dye can be washed out by the sample, which makes such strips unsuitable for applications wherein indicator contamination is unacceptable and for continuous processes. In addition, in many cases, upon dn~ing such strips loose their pH indicative color.
w0 01/13097 PCT/US00/21129 By means of chemical or physical immobilization of dyes washing out can be prevented. Immobilized pH-sensitive materials are therefore suitable for the continuous measurement of pH and for applications wherein indicator contamination are unacceptable.
s An early study of bacterial vaginosis (BV) involved comparisons of the pH of vaginal fluids of women known to be suffering from BV
with those known to be free of the disease. Gardner, H. L., et al., Am. J.
Obstet. Gynecol. 69:962 (1955). All of the BV positive women in the study were determined to have a vaginal fluid pH greater than 4.5, and 91 % of these women had a vaginal fluid pH greater than ~Ø Of the normal (disease-free) women in the test, 92 % were found to have vaginal pH between 4.0 and 4.7. The conclusion drawn from the study was that a vaginal pH equal to or greater than 5.0 in conjunction with other clinical criteria was indicative of the presence of BV.
is Subsequent studies culminating by Amsel, R., et al., Am. J. Med.
74:14-22 (1983), resulted in a reduction of the pH threshold for BV to 4.5, and established the remaining criteria as vaginal fluid homogeneity, the whiff test (treatment with alkali followed by an olfactory test to detect for an amine odor), and the presence of clue cells. These are commonly 2o referred to as the Amsel clinical criteria for BV. The conclusion was based on a study group of 397 women in which 81 % of BV positive women were found to have a pH greater than 4.5 while only 23 % of the normal women were found to have a vaginal fluid pH greater than 4.5.
Studies subsequent to the report by Amsel et al. have now adjusted 2s the pH threshold to 4.7. One of these is the study of Holst, E., J. Clin.
Microbiol. 28:203-2039 (1990), in which 100 % of the women diagnosed as BV positive by the Amsel criteria were reported to have vaginal fluid pH greater than 4.7. Another is the study by Eschenbach, D. A., Am. J. Obstet. Gvnecol. 168(4):819-828 (1988), in which all 2~7 w0 01/13097 PCT/US00/21129 p women in the study group who had at least 20 % clue cells were shown to have a vaginal fluid pH greater than or equal to 4.7, leading to the conclusion that a threshold value of 4.7 correlated best with the other clinical evidence of BV. Krohn, M. A., et al., J. Clin. Microbiol.
s 27(6):1266-1271 (1989), also verified the correlation between the vaginal fluid pH threshold of 4.7 and the presence of clue cells, and Hohnes, K.
K., and coworkers further confirmed the pH 4.7 threshold as an indicator of BV--Holmes, K. K., et al., eds., Sexually Transmitted Diseases, McGraw-Hill, New York (1990), Chapter 46:527-545 (Hohnes, K. K., et al.), and Chapter 47:547-5~9 (Hillier, S. L., et al.).
Colorimetric tests for elevated vaginal fluid pH have used nitrazine yellow as an indicator. Nitrazine yellow is a monoazo dye that is bright yellow at pH 6.0 and bright blue at pH 7.2, and has a grey-green midpoint at pH 6.6. In the range of interest for testing vaginal fluid, ~s however, which is approximately 3.~ to 6Ø the change occurs in subtle progressions of grey-green that are difficult to interpret.
pH thresholds are useful indicators in diagnosing a variety of other biological conditions, in both humans and animals, and a large number of colorimetric indicators are known and commercially available. Selection 20 of the appropriate indicator is not always a simple task, however, and the choices are often limited, particularly when a specific color change is desired and when stability of the indicator is a consideration.
Normal bovine milk, for example, has a pH of 6.5 to 6.8, and it has been reported (N. Z. J. Sci. Technol. 27:258 (1945)) that bovine milk 2s with a pH greater than 6.8 may indicate the presence of bovine mastitis.
The difficulties of detecting a pH deviation of such a small magnitude using conventional paper indicator strips are discussed above.
A study specifically directed to bovine mastitis was reported in J.
Dairv Sci. 68: 1263-1269 (198x). The purpose of the study was to w0 01/13097 PCT/US00/21129 determine the suitability of using absorbent blotting paper impregnated with the pH indicator bromthymol blue to test the pH of bovine milk as a method of detecting subclinical bovine mastitis. Milk was added to the indicator-treated paper, and the color of the pH indicator spot was scored s on a scale of 1 to 4, where 1 (pale green) was assessed as normal (negative), and 2, 3 and 4 (increasing from moderate green to dark blue-green) were considered abnormal (positive). The pH of the milk was also determined electronically with a carefully calibrated pH meter.
The test results illustrated the difficulty in defining accurately the color ~o of the test area: the predictive value of a positive colorimetric test ranged from 49 % to 52 % (i.e.. 51 % to 48 % of the results were false positives).
As expected, an increase in the test score was accompanied by an increase in the severity of mastitis as defined by other diagnostic Is measures. However, in milk from animals with less severe mastitis, the considerable overlapping of results highlighted the possible error in interpretation of indicator scores. The wide variation of milk pH as determined electronically within each BTB (Brow Thvmol Blue) color score showed that the indicator results were not closely related to pH.
2o The investigators stressed the importance of using color comparators which resemble as closely as possible the actual pH test method being utilized. If the colorimetric milk pH test results were to be interpreted immediately, it was important to use comparators that were also wetted with milk. If the calorimetric pH test results were to be determined after 2s the milk spots had dried, it was advantageous to use dn~ comparators.
Returning to bacterial vaginosis, the whiff test, which is one of the Amsel criteria, originated in a study by Pheifer, et al., N. Engl. J. Med.
298:1429-1434 (1978), that reported the presence of a characteristic fishy amine odor upon the addition of 10 ° o KOH to a vaginal fluid specimen w0 01/13097 PCT/US00/21129 from a woman with BV. The odor is caused by the alkaline volatilization of amine salts found in the vaginal fluid of women with BV.
Unfortunately. the test is highly subjective, it exposes the health care worker to potential biological hazards, and it is disagreeable and s vulnerable to error, since it is performed on a microscope slide which, due to the transient nature of the amine odor, must be placed directly under the nose and sniffed immediately after the addition of the KOH.
Alternatives to the whiff test are analyrtical procedures such as high voltage electrophoresis (Chen, K. C. S., et al., J. Clin. Invest.
~0 63:828-835 (1979)). thin-layer chromatography (Chen, K. C. S., et al., J.
Infect. Dis. 145:337-345 (1982), and Sanderson, B. E., et al., Br. J.
Vener. Dis. 59:302-305 (1983)), gas chromatography (Graven, M. G., et al. Obstet. Gynecol. 67:229-237 (1986), and Dravenieks, A., et al., J.
Pharma. Sc. 59:495-501 ( 1970)), and high-performance liquid Is chromatography (Cook, R. L., et al., J. Clin. Microbiol. 30:870-877 ( I 992)). These procedures, although more accurate and reliable than the whiff test, are expensive, time-consuming, and not suitable for on-site testing in a physician's office or clinic.
Clue cells, which constitute a further Amsel criterion, are 2o independently correlated with BV, and in the hands of a skilled microscopist are a very sensitive and specific indication of this infection.
Clue cells are squamous vaginal epithelial cells found in vaginal fluid when BV is present. The cells are covered with numerous bacteria, giving them a stippled or granular appearance, and their borders are ?s obscured or fuzzy because of the adherence of numerous rods or cocci.
According to standard clinical practice, a diagnosis of BV is established when at least 20% of the detectable epithelial cells are clue cells.
Holmes, et al., Sexually Transmitted Diseases. 2d ed., McGraw-Hill, Inc., New York. 1990.
Distinguishing between true clue cells in which the adherent bacteria completely obscure the edges of the cells and cells with simply a few adherent bacteria requires training and experience. One source of error is similarity in appearance between clue cells and trichomonads, s white blood cells and other vaginal fluid components, frequently resulting in an incorrect identification of these cells as clue cells, and therefore false positive test results. Another is that clue cells when present are frequently obscured by numerous vaginal fluid components causing the clinician to miss the clue cells completely or to quantify them ~o at levels below their actual level. This can result in a false negative test result. Therefore, it would be highl~~ desirable to have a distinct analyte that is accurately and conveniently monitored and whose presence is correlated with clue cells.
U.S. Pat. No. 5,217,444 to Schoenfeld teaches an absorbent pad, for use in absorbing secretions from a person's body, which includes a pH
indicator material indicating by a color change the acidity or alkalinity of a liquid coming into contact with it. The pH indicator material is wetted by the secretions absorbed by the pad. and thereby provides an indication of the health condition of the person's body.
2o U.S. Pat. No. 5,853,669 to Wolfbeis teaches a hydrophilic accommodating layer disposed on a hydrophobic mechanically stable support element, which layer contains an indicator dye proper in an immobilized form for the purpose of visual or optical indication of the pH of a sample which can be used as the pH indicator in the pad of 2s Schoenfeld and in other applications as well.
SUMMARY OF THE INVENTION
One object of the present invention is to improve a pH sensor of the type mentioned in the preamble and a process for fabricating a pH
sensor of this type, so as to enable a simple fabrication or even mass production of pH sensors which are inexpensive and thus suitable as an expendable pH sensor.
Another object of the present invention is to provide hygienic pads s in which a pH sensor as herein described is incorporated for monitoring a user's health condition.
Still another object of the present invention is to provide an efficient method of selecting pH indicator dyes and/or dyes ratio for obtaining a pH indicator dye mixture which is sensitive to a subtle change in pH.
Thus, according to one aspect of the present invention there is provided a pH sensor for the visual or optical indication of the pH of a sample, the pH sensor comprising a hydrophilic, intrinsically charged or neutral, synthetic membrane and at least one pH indicator dye immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
According to another aspect of the present invention there is provided a method of manufacturing a non-bleeding pH sensor, the 2o method comprising the step of immobilizing at least one pH indicator dye onto a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
2s According to yet another aspect of the present invention there is provided an absorbent body for absorbing vaginal discharge of a person, comprising an absorbent material and a pH sensor being combined therewith for the visual or optical indication of the pH of the vaginal discharge, the pH sensor including a hydrophilic. optionally intrinsically h charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid, the pH sensor being included in the absorbent body so as s to be wetted by the secretions absorbed by the absorbent material, thereby providing an indication of the health condition of the person's body.
According to still another aspect of the present invention there is provided a method of providing an indication of the health condition of a person's body, the method comprising the steps of (a) collecting vaginal discharge of the person into an absorbent body including an absorbent material and a pH sensor being combined therewith for the visual or optical indication of the pH of the vaginal discharge, the pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, ~ s so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid, the pH sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material; and (b) optically inspecting the pH sensor for a color change, thereby providing an 2o indication of the health condition of the person's body.
According to a further aspect of the present invention there is provided a method of producing an absorbent body for absorbing vaginal discharge of a person and for providing an indication of the health condition of the person's body, the method comprising the step of 2s combining an absorbent material and a pH sensor, the pH sensor being for the visual or optical indication of the pH of the vaginal discharge, the pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto. so as to prevent appreciated bleeding of the at least one indicator w0 01/13097 PCT/US00/21129 dye from the synthetic membrane upon immersion in an aqueous liquid, the pH sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material, thereby providing an indication of the health condition of the person's body.
s According to further features in preferred embodiments of the invention described below. the at least one pH indicator dye is sensitive to a subtle change in pH of less than N pH units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units and 0.1 pH units.
to According io still further features in the described preferred embodiments the hydrophilic synthetic membrane is positively charged.
According to still further features in the described preferred embodiments the hydrophilic synthetic membrane is negatively charged.
According to still further features in the described preferred t, embodiments the hydrophilic synthetic membrane is amphoteric.
According to still further features in the described preferred embodiments the hydrophilic synthetic membrane is a Nylon membrane.
According to still further features in the described preferred embodiments the Nylon is Nylon 6.6.
2o According to still further features in the described preferred embodiments hydrophilic synthetic membrane is a polyamide membrane.
According to still further features in the described preferred embodiments hydrophilic synthetic membrane is an arylamide membrane.
According to still further features in the described preferred ?s embodiments the at least one pH indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
According to an additional aspect of the present invention there is provided a method of selecting pH indicator dyes and dyes ratio for obtaining a pH indicator dve mixture which is sensitive to a subtle w0 01/13097 PCT/US00/21129 change in pH, the method comprising the steps of (a) providing a plurality of transparent containers; (b) dividing the plurality of transparent containers into pH groups by filling containers of each of the pII groups with a buffered solution of a predetermined pH value; (c) s introducing into each of the plurality of containers a single pH indicator dye of a known concentration, such that different containers of a single group of containers include different pH indicator dyes and optionally different concentrations of a specific pH indicator dye; (d) selecting at least two containers of a specific pH group, each of the at least two ~ o containers including a different pH indicator dye and positioning the at least two containers against a light source so as to optically monitor a color obtained by combining color contributions of each of the at least two containers; and (d) optionally repeating step (d) with containers of one or more of the pH groups until identifying pH indicator dyes and/or dyes ratio, such that when mixed to form the pH indicator dye mixture will be sensitive to the subtle change in pH.
According to further features in preferred embodiments of the invention described below, the subtle chance in pH is of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units and 0.1 pH units.
The present invention successfully addresses the shortcomings of the presently known configurations by providing a pH sensor for the visual or optical indication of the pH of a sample, an method of manufacturing same, an absorbent body for absorbing vaginal discharge ?s of a person including same, a method of providing an indication of the health condition of a person's body using same, a method of producing an absorbent body for absorbing vaginal discharge of a person and for providing an indication of the health condition of the person's body and a w0 01/13097 PCT/US00/21129 method of selecting pH indicator dyes and dyes ratio for obtaining a pH
indicator dye mixture which is sensitive to a subtle change in pH.
BRIEF DESCRIPTION OF THE DRAWINGS
s The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:
FIG. 1 is a top view of a pH sensor according to the present mvent~on;
FIG. 2 is a top view of a hygienic pad including the pH sensor according to the present invention;
FIG. 3 is a perspective view of a tampon including the pH sensor according to the present invention; and FIG. 4 is a graph showing the change in color as a function of pH
for 0.1 % Bromocresol Green as is compared with a mixture of 1 volume t s of Bromocresol Green mixed with 3 volumes of 0.1 % Methyl Orange.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present invention is of a pH sensor for the visual or optical indication of the pH of a sample which can be used in an absorbent body 2o for absorbing vaginal discharge of a person. Specif cally the present invention can be used to provide an indication of the health condition of a person's body. The present invention is further of a method of manufacturing a pH sensor for the visual or optical indication of the pH
of a sample, a method of producing an absorbent body for absorbing 2s vaginal discharge of a person and for providing an indication of the health condition of the person's body and a method of selecting pH
indicator dyes and/or dyes ratio for obtaining a pH indicator dye mixture which is sensitive to a subtle change in pH.
l~
The principles and operation of the present invention may be better understood with reference to the drawings and accompanying descriptions.
Before explaining a1 least one embodiment of the invention in s detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments or of being practiced or carried out in various ways. Also, it is to be understood that i o the phraseology and terminology employed herein is for the purpose of description and should not be regarded as limiting.
As shown in Figure l, according to one aspect of the present invention there is provided a pH sensor 10 for the visual or optical indication of the pH of a sample. pH sensor 10 includes a hydrophilic, > > optionally intrinsically charged or neutral, synthetic membrane and at least one pH indicator d5~e immobilized thereto, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic membrane upon immersion in an aqueous liquid.
As used herein in the specification and in the claims section that 2o follows, the phrase "a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane" refers to non-natural membranes which are positively charged, such as the BIODYNE B/PLUS membrane by PALL
Gelman Laboratory, membranes which are negatively charged, such as the BIODYNE C membrane by PALL Gelman Laboratory, membranes 2s which are amphoteric, such as the BIODYNE A membrane by PALL
Gehnan Laboratory. Such a synthetic membrane can be made of any suitable synthetic polymer, such as, but not limited to polyamide (Nylon.
e.g., Nylon 6.6) and arylamide. Synthetic membranes are presently preferred over fibrous natural membranes such as nitrocellulose based membranes because it was experimentally determined that (t) such membranes better maintain their structural integrity under wider pH
ranges as is compared with natural membranes such as cellulose or nitrocellulose based membranes; and (ii) such membranes readily s immobilize a plurality of pH indicator dyes.
As used herein in the specification and in the claims section that follows, the phrase "at least one pH indicator d5~e" refers to a single pH
indicator dye or a mixture of at least two different pH indicator dyes, wherein in different mixtures each of the at least one pH indicator dye ~o may be present in a different concentration.
As used herein in the specification and in the claims section that follows, the phrase "appreciated bleeding" refers to eye detectable leakage of the at least one pH indicator dye into an aqueous liquid, such as a buffer solution, in a predetermined pH range, e.g., of 2 pH units, t, through which color change of the pH indicator dye is experienced, over a predetermined time period, e.g., 24 hours, at a temperature beriveen e.g., 22 °C and 37 °C. The phrase also refers to eye detectable leakage of the at least one pH indicator dye onto a wet white fibrous material.
According to another aspect of the present invention there is 2o provided a method of manufacturing a non-bleeding pH sensor. The method according to this aspect of the present invention is effected by immobilizing at least one pH indicator dye onto a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane, so as to prevent appreciated bleeding of the at least one indicator dye from the synthetic 2s membrane upon immersion in an aqueous liquid. Immobilization according to this aspect of the present invention can be effected by immersing the membrane in an aqueous solution of the at least one pH
indicator in an appropriate concentration. ranging between 0.01 w/v and 1 w/v % for several hours, e.g.. at least 4 hours, preferably at least 6 1 ~1 hours, more preferably at least 10 hours. still more preferably at least 15 or 20 hours, followed by washing the membrane in a wash solution and immobilizing the at least one pI-I indicator dye thereto by an immobilization method, such as. but not limited to, placing the membrane s over an absorbing material and drying the membrane under low humidity conditions (e.g., not more than 30 % air humidity) at, for example, room temperature, for several hours. It was experimentally determined that using the above protocol, a variety of pH indicator dyes were immobilized to an amphoteric Nylon membrane and showed no appreciated bleeding thereafter.
A unique feature of the protocol herein described is the stability of the color change of pH sensor 10. Thus, while prior art pH strips change color, the color is maintained thereby as long as the strip is kept humid, however, the color fades upon drying. While practicing the above Is protocol, the inventors were surprised to find out that for a plurality of pH indicators tested, the color change developed following pH change remained substantially unchanged and in some cases became more pronounced after drying. For example, by mixing I volume of 0.1 Bromocresol Green with 3 volumes of Methyl Orange and immobilizing 2o the pH indicator dyes mixture onto an amphoteric Nylon membrane as herein described a pH sensor was obtained which was lemonish at pHs 4.2 and 4.4 and turned bluish-green at pH 4.6. The bluish-green color was maintained substantially unchanged also after drying the membrane and keeping it dry for over two weeks.
2s According to a preferred embodiment, both the aqueous solution and the wash solution are either a buffered solution or a non-buffered solution, respectively, having a pH value in a range of less than ~ 0.5-1.0 pH units of the pH value inducing a color change on the at least one pH
indicator.
1i Thus, the present invention provides an assay for pairing appropriate membranes with appropriate pH indicator dyes. According to this assay, any one of the above described membranes is tested for appreciated bleeding following the immobilization protocol as herein described. This assay can be rendered more sensitive by spectroscopically monitoring the bleeding to thereby determine bleeding, if any.
As shown in Figures 2-3, according to yet another aspect of the present invention there is provided an absorbent body 14 for absorbing ~ o vaginal discharge of a person. Absorbent body 14 includes an absorbent material 16 which, as shown in Figure 2, can be arranged in a flattened layers configuration, such a hygienic pad, or, as specifically shown in Figure 3, rolled or folded into a compact configuration, such as a tampon.
In any case, absorbent body 14 further includes a pH sensor, such as pH
t > sensor 10 as described hereinabove, which is combined with material 16 for the visual or optical indication of the pH of the vaginal discharge.
Thus, pH sensor 10 is included in absorbent body 14 so as to be wetted by the secretions absorbed by absorbent material 16, thereby to provide an indication of the health condition of the person's body, as is further 2o detailed in the background section above and in U.S. Pat. Nos. x,217,444 to Schoenfeld and 5,83,669 to Wolfbeis both are incorporated by reference as if fully set forth herein. pH sensor 10 can be located at any location with respect to, for example, pad 14 of Figure 2. It is preferably centered. It can be located at either side of pad 14. Similarly, pH sensor ?s 10 can be located at any location with respect to, for example, tampon 14 of Figure 3. It is preferably centered. In both cases, pH sensor 10 can be either externally attached to material 16 body 14 or internally embedded between layers of material 16. Material 16 can be any absorbent substance, including. but not limited to, natural fibers, such as cotton w0 01/13097 PCT/US00/21129 fibers, or a gelating substance, as well known in the art. Additional layers, such as an external protective, water impermeable, layer 18 can be employed, as well known in the art. Such a protective layer 18 is preferably selected transparent, so as to enable a user to view pH sensor and any color change thereof therethrough.
According to still another aspect of the present invention there is provided a method of providing an indication of the health condition of a person's body. The method according to this aspect of the present invention is effected by collecting vaginal discharge of the person into an to absorbent body such as absorbent body 14 described hereinabove and optically inspecting, e.g., by a colorimeter or by eye inspection, the pH
sensor for a color change, thereby providing an indication of the health condition of the person's body in relation to bacterial vaginosis, all as further detailed in the background section above.
1 s According to a further aspect of the present invention there is provided a method of producing an absorbent body for absorbing vaginal discharge of a person and for providing an indication of the health condition of the person's body. The method according to this aspect of the present invention is effected by combining an absorbent material and 2o a pH sensor as further detailed hereinabove.
As is further detailed in the background section above subtle pH
changes are in some cases indicative of a pathological state. Therefore, according to a preferred embodiment of the present invention. the at least one pH indicator dye is selected sensitive to a subtle change in pH, such 2s as, but not limited to, less than 0.~ pH units, less than 0.4 pH units, less than 0.3 pH units, less than 0.2 pH units or less than 0.1 pH units. The sensitivity should be tailored to the application. Thus, for diagnosis of bacterial vaginosis pH change of about 0.4 pH units is of choice. In this case. the at least one pH indicator dye produces a color chance at a pH of w0 01/13097 PCT/US00/21129 between pH value of 4.0 and 5Ø preferably between pH value of 4.2 and 4.6.
According to an additional aspect of the present invention there is provided a method of selecting pH indicator dye combinations and dyes s ratios) for obtaining a pH indicator dye mixture which is sensitive to a subtle change in pH. The method according to this aspect of the present invention is effected by implementing the following method steps, in which, in a first step, a plurality of transparent containers are provided.
The containers are preferably cubic containers. such as quvettes, e.g., quartz or glass quvettes. In a second step of the method according to this aspect of the present invention the plurality of transparent containers are divided into pH groups by filling containers of each of the pH groups with a buffered solution of a predetermined pH value. Containers of different pH groups are filled with buffers which differ by subtle pH
t, values, such as less than 0.~ pH units, less than 0.4 pH units, less than 0.3 pH units, less than 0.2 pH units, less than 0.1 pH units or for some applications less than 0.05 pH units, and the groups cover a suitable pH
range of e.g., about I .0 pH unit. say betveen pH 4.0 and pH ~Ø Then, into each of the plurality of containers a single pH indicator dye of a 2o known concentration is introduced, such that different containers of a single group of containers include different pH indicator dyes and optionally different concentrations of a specific pH indicator dye.
Thereafter, at least two containers of a specific pH group are selected.
Each of the at least two containers include a different pH indicator dye.
2> The selected containers are positioned against a light source, such as a white light source, so as to optically monitor by a colorimeter (e.g., spectrophotometer) or by eye inspection, a color obtained by combining color contributions of each of the at least two containers so positioned.
Finally. the former step is repeated with containers of one or more of the pH groups until pH indicator dues combination and/or dyes ratios) is obtained, such that when mixed to form the pH indicator dye mixture, that mixture will be sensitive to the subtle change in pH in the specified pH range.
This method was practiced in order to combine pairs of pH
indicator dies in order to obtain an indicator dye mixture which changes its color when shifting the pH from pH 4.4 to pH 4.6. As further detailed in the background section above, such a pH indicator is useful in the diagnosis of bacterial vaginosis. Table 1 below summarizes the results.
to 1st pH indicator1st pH indicatorV.R. Color change dye dye Bromocresol Methyl Orange 1/4 Lemon - Bluish Green green Mixed indicatorMix 3046 1/1 Pint: - Blue 4.5 Mixed indicatorBromocresol Green1/1 Brown -Blue 4.5 Congo red Bromocresol Green111 and Brown - Blue BromochlorophenolBromocresol Green1 /2 Grey - Violet Blue V.R. = volume ratio employed. All pH indicator dyes were employed at a concentration of 1 w/v % in water or water mixed with some ethanol. Bromocresol Green (3', 3", 5', 5"
tertrabromo-m-cresolsulfonephtalalein, Sigma B-7396); Methyl Orange (Acid orange 52, Sigma M-0402); Mixed indicator 4.5 (Merck I.OB59.0250); Mix 3046 (BDH 21038 4A);
Congo red (Aldrich Chem. 86,095-6); Bromochlorophenol Blue (Sigma B-5008) Figure 4 is a graph demonstrating the color change using a 2o mixture of two indicators as compared to a single indicator. Thus, 0.1 Bromocresol Green gradually changes color from yellow to bluish green from pH 3.5 to pH 4.7, after which no substantial further color change is monitorable. In sharp contrast, by mixing 1 volume of 0.1 Bromocresol Green with 3 volumes of Methyl Orange a pH indicator dye mixture is obtained which is lemonish at pHs 3.5 to 4.~ and step wise changes to a bluish-green color at pH -1.~.
w0 01/13097 PCT/US00/21129 Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art.
Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims.
Finally. the former step is repeated with containers of one or more of the pH groups until pH indicator dues combination and/or dyes ratios) is obtained, such that when mixed to form the pH indicator dye mixture, that mixture will be sensitive to the subtle change in pH in the specified pH range.
This method was practiced in order to combine pairs of pH
indicator dies in order to obtain an indicator dye mixture which changes its color when shifting the pH from pH 4.4 to pH 4.6. As further detailed in the background section above, such a pH indicator is useful in the diagnosis of bacterial vaginosis. Table 1 below summarizes the results.
to 1st pH indicator1st pH indicatorV.R. Color change dye dye Bromocresol Methyl Orange 1/4 Lemon - Bluish Green green Mixed indicatorMix 3046 1/1 Pint: - Blue 4.5 Mixed indicatorBromocresol Green1/1 Brown -Blue 4.5 Congo red Bromocresol Green111 and Brown - Blue BromochlorophenolBromocresol Green1 /2 Grey - Violet Blue V.R. = volume ratio employed. All pH indicator dyes were employed at a concentration of 1 w/v % in water or water mixed with some ethanol. Bromocresol Green (3', 3", 5', 5"
tertrabromo-m-cresolsulfonephtalalein, Sigma B-7396); Methyl Orange (Acid orange 52, Sigma M-0402); Mixed indicator 4.5 (Merck I.OB59.0250); Mix 3046 (BDH 21038 4A);
Congo red (Aldrich Chem. 86,095-6); Bromochlorophenol Blue (Sigma B-5008) Figure 4 is a graph demonstrating the color change using a 2o mixture of two indicators as compared to a single indicator. Thus, 0.1 Bromocresol Green gradually changes color from yellow to bluish green from pH 3.5 to pH 4.7, after which no substantial further color change is monitorable. In sharp contrast, by mixing 1 volume of 0.1 Bromocresol Green with 3 volumes of Methyl Orange a pH indicator dye mixture is obtained which is lemonish at pHs 3.5 to 4.~ and step wise changes to a bluish-green color at pH -1.~.
w0 01/13097 PCT/US00/21129 Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art.
Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims.
Claims (52)
1. A pH sensor for the visual or optical indication of the pH of a sample, the pH sensor comprising a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one pH indicator dye immobilized thereto, so as to prevent appreciated bleeding of said at least one indicator dye from said synthetic membrane upon immersion in an aqueous liquid.
2. The pH sensor of claim 1, wherein said at least one pH
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
3. The pH sensor of claim 1, wherein said hydrophilic synthetic membrane is positively charged.
4. The pH sensor of claim 1, wherein said hydrophilic synthetic membrane is negatively charged.
5. The pH sensor of claim 1, wherein said hydrophilic synthetic membrane is amphoteric.
6. The pH sensor of claim 1, wherein said hydrophilic synthetic membrane is a Nylon membrane.
7. The pH sensor of claim 6, wherein said Nylon is Nylon 6.6.
8. The pH sensor of claim 1, wherein said hydrophilic synthetic membrane is a polyamide membrane.
9. The pH sensor of claim 1, wherein said hydrophilic synthetic membrane is an arylamide membrane.
10. The pH sensor of claim 1, wherein said at least one pH
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
11. An absorbent body for absorbing vaginal discharge of a person, comprising an absorbent material and a pH sensor being combined therewith for the visual or optical indication of the pH of the vaginal discharge, said pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, so as to prevent appreciated bleeding of said at least one indicator dye from said synthetic membrane upon immersion in an aqueous liquid. said pH sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material, thereby providing an indication of the health condition of the person's body.
12. The pH sensor of claim 11, wherein said at least one pH
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units. 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units. 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
13. The pH sensor of claim 11, wherein said hydrophilic synthetic membrane is positively charged.
14. The pH sensor of claim 11, wherein said hydrophilic synthetic membrane is negatively charged.
15. The pH sensor of claim 11, wherein said hydrophilic synthetic membrane is amphoteric.
16. The pH sensor of claim 11, wherein said hydrophilic synthetic membrane is a Nylon membrane.
17. The pH sensor of claim 16, wherein said Nylon is Nylon 6.6.
18. The pH sensor of claim 11, wherein said hydrophilic synthetic membrane is a polyamide membrane.
19. The pH sensor of claim 11, wherein said hydrophilic synthetic membrane is an arylamide membrane.
20. The pH sensor of claim 11, wherein said at least one pH
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
21. A method of providing an indication of the health condition of a person's body, the method comprising the steps of:
(a) collecting vaginal discharge of the person into an absorbent body including an absorbent material and a pH sensor being combined therewith for the visual or optical indication of the pH of the vaginal discharge, said pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, so as to prevent appreciated bleeding of said at least one indicator dye from said synthetic membrane upon immersion in an aqueous liquid, said pH
sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material; and (b) optically inspecting said pH sensor for a color change, thereby providing an indication of the health condition of the person's body.
(a) collecting vaginal discharge of the person into an absorbent body including an absorbent material and a pH sensor being combined therewith for the visual or optical indication of the pH of the vaginal discharge, said pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, so as to prevent appreciated bleeding of said at least one indicator dye from said synthetic membrane upon immersion in an aqueous liquid, said pH
sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material; and (b) optically inspecting said pH sensor for a color change, thereby providing an indication of the health condition of the person's body.
22. The method of claim 21, wherein said at least one pH
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
23. The method of claim 21, wherein said hydrophilic synthetic membrane is positively charged.
24. The method of claim 21, wherein said hydrophilic synthetic membrane is negatively charged.
25. The method of claim 21, wherein said hydrophilic synthetic membrane is amphoteric.
26. The method of claim 21, wherein said hydrophilic synthetic membrane is a Nylon membrane.
27. The method of claim 26, wherein said Nylon is Nylon 6.6.
28. The method of claim 21, wherein said hydrophilic synthetic membrane is a polyamide membrane.
29. The method of claim 21, wherein said hydrophilic synthetic membrane is an arylamide membrane.
30. The method of claim 21, wherein said at least one pH
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
31. A method of producing an absorbent body for absorbing vaginal discharge of a person and for providing an indication of the health condition of the person's body, the method comprising the step of combining an absorbent material and a pH sensor, said pH sensor being for the visual or optical indication of the pH of the vaginal discharge, said pH sensor including a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane and at least one indicator dye immobilized thereto, so as to prevent appreciated bleeding of said at least one indicator dye from said synthetic membrane upon immersion in an aqueous liquid, said pH sensor being included in the absorbent body so as to be wetted by the secretions absorbed by the absorbent material, thereby providing an indication of the health condition of the person's body.
32. The method of claim 21, wherein said at least one pH
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
33. The method of claim 21, wherein said hydrophilic synthetic membrane is positively charged.
34. The method of claim 21, wherein said hydrophilic synthetic membrane is negatively charged.
35. The method of claim 21, wherein said hydrophilic synthetic membrane is amphoteric.
36. The method of claim 21, wherein said hydrophilic synthetic membrane is a Nylon membrane.
37. The method of claim 26, wherein said Nylon is Nylon 6.6.
38. The method of claim 21, wherein said hydrophilic synthetic membrane is a polyamide membrane.
39. The method of claim 21, wherein said hydrophilic synthetic membrane is an arylamide membrane.
40. The method of claim 21, wherein said at least one pH
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
41. A method of manufacturing a non-bleeding pH sensor, the method comprising the step of immobilizing at least one pH indicator dye onto a hydrophilic, optionally intrinsically charged or neutral, synthetic membrane, so as to prevent appreciated bleeding of said at least one indicator dye from said synthetic membrane upon immersion in an aqueous liquid.
42. The method of claim 41, wherein said at least one pH
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
indicator dye is sensitive to a subtle change in pH of less than N pH
units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
43. The method of claim 41, wherein said hydrophilic synthetic membrane is positively charged.
44. The method of claim 41, wherein said hydrophilic synthetic membrane is negatively charged.
45. The method of claim 41, wherein said hydrophilic synthetic membrane is amphoteric.
46. The method of claim 41, wherein said hydrophilic synthetic membrane is a Nylon membrane.
47. The method of claim 46, wherein said Nylon is Nylon 6.6.
48. The method of claim 41, wherein said hydrophilic synthetic membrane is a polyamide membrane.
49. The method of claim 41, wherein said hydrophilic synthetic membrane is an arylamide membrane.
50. The method of claim 41, wherein said at least one pH
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
indicator dye produces a color change at a pH of between pH value of 4.0 and 5Ø
51. A method of selecting pH indicator dyes and dyes ratio for obtaining a pH indicator dye mixture which is sensitive to a subtle change in pH, the method comprising the steps of:
(a) providing a plurality of transparent containers;
(b) dividing said plurality of transparent containers into pH
groups by filling containers of each of said pH groups with a buffered solution of a predetermined pH value;
(c) introducing into each of said plurality of containers a single pH indicator dye of a known concentration, such that different containers of a single group of containers include different pH indicator dyes and optionally different concentrations of a specific pH indicator dye;
(d) selecting at least two containers of a specific pH group, each of said at least two containers including a different pH
indicator dye and positioning said at least two containers against a light source so as to optically monitor a color obtained by combining color contributions of each of said at least two containers; and (d) optionally repeating step (d) with containers of one or more of said pH groups until identifying pH indicator dyes and/or dyes ratio, such that when mixed to form the pH indicator dye mixture will be sensitive to the subtle change in pH.
(a) providing a plurality of transparent containers;
(b) dividing said plurality of transparent containers into pH
groups by filling containers of each of said pH groups with a buffered solution of a predetermined pH value;
(c) introducing into each of said plurality of containers a single pH indicator dye of a known concentration, such that different containers of a single group of containers include different pH indicator dyes and optionally different concentrations of a specific pH indicator dye;
(d) selecting at least two containers of a specific pH group, each of said at least two containers including a different pH
indicator dye and positioning said at least two containers against a light source so as to optically monitor a color obtained by combining color contributions of each of said at least two containers; and (d) optionally repeating step (d) with containers of one or more of said pH groups until identifying pH indicator dyes and/or dyes ratio, such that when mixed to form the pH indicator dye mixture will be sensitive to the subtle change in pH.
52. The method of claim 51, wherein said subtle change in pH
is of less than N pH units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
is of less than N pH units, wherein N is selected from the group consisting of 0.5 pH units, 0.4 pH units, 0.3 pH units, 0.2 pH units, 0.1 pH units and 0.05 pH units.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US09/372,571 US6562297B1 (en) | 1999-08-12 | 1999-08-12 | pH sensor for indicating the pH of a sample |
US09/372,571 | 1999-08-12 | ||
PCT/US2000/021129 WO2001013097A1 (en) | 1999-08-12 | 2000-08-03 | pH SENSOR FOR INDICATING THE pH OF A SAMPLE, THE FABRICATION AND USE THEREOF |
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CA2380925A1 true CA2380925A1 (en) | 2001-02-22 |
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Application Number | Title | Priority Date | Filing Date |
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CA002380925A Abandoned CA2380925A1 (en) | 1999-08-12 | 2000-08-03 | Ph sensor for indicating the ph of a sample, the fabrication and use thereof |
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US (1) | US6562297B1 (en) |
EP (1) | EP1208368A4 (en) |
JP (1) | JP2003507706A (en) |
AU (1) | AU6397300A (en) |
CA (1) | CA2380925A1 (en) |
IL (2) | IL148108A0 (en) |
WO (1) | WO2001013097A1 (en) |
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- 1999-08-12 US US09/372,571 patent/US6562297B1/en not_active Expired - Lifetime
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- 2000-08-03 CA CA002380925A patent/CA2380925A1/en not_active Abandoned
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- 2000-08-03 AU AU63973/00A patent/AU6397300A/en not_active Abandoned
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- 2000-08-03 EP EP00950948A patent/EP1208368A4/en not_active Ceased
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2002
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EP1208368A4 (en) | 2007-09-26 |
EP1208368A1 (en) | 2002-05-29 |
AU6397300A (en) | 2001-03-13 |
US6562297B1 (en) | 2003-05-13 |
IL148108A (en) | 2008-07-08 |
JP2003507706A (en) | 2003-02-25 |
WO2001013097A1 (en) | 2001-02-22 |
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